Cystoscopy. Your cystoscopy is scheduled at the Ambulatory Procedure Center at Altru Clinic - Main, 4-south waiting room.

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Improving Health, Enriching Life Cystoscopy Your cystoscopy is scheduled at the Ambulatory Procedure Center at Altru Clinic - Main, 4-south waiting room. Arrival Time: Appointment Date:

Normal Female Urinary Anatomy Ureters Bladder Urethra Normal Male Urinary Anatomy Ureters Bladder Prostate Urethra

What is a cystoscopy? A cystoscopy is a procedure used to diagnose or treat problems of the urinary tract. It is an examination of the inside lining of the bladder and the urethra (the tube in which urine passes from the bladder to outside the body). This procedure is most often done in a clinic outpatient area with local anesthetic (you are awake). Cystoscopy is only occasionally done in an operating room while a person is under general anesthetic (asleep). What problems are investigated by cystoscopy?» Inability to pass urine or empty the bladder» Blood in the urine» Persistent pain when voiding (passing urine)» Difficulty passing urine» Urgency and increased frequency of passing urine» Repeated urinary infections» Abnormal findings on X-rays of the bladder or urethra How is a cystoscopy done? You will be positioned either flat on your back (for men) OR with your knees bent and your feet supported in stirrups (for women). Your genital area will be cleaned with antiseptic and you will be draped with a sterile sheet. After the anesthetic has been given, the doctor will gently insert the cystoscope. A cystoscope is a lighted tube that is inserted up the urethra into the bladder. When the scope is in your bladder, sterile water is inserted into your bladder to expand it and provide a clear view of the urethra and bladder lining. When the examination is completed, the scope and water are removed. The procedure takes between 5 and 20 minutes depending on what is done during the cystoscopy.

How will I feel during a cystoscopy? When a local anesthetic is used, you may feel a pressure or burning sensation or an urge to pass urine, as the cystoscope is inserted. Also, when the sterile water is added to your bladder, you may feel a cool sensation and uncomfortable fullness. You can help relieve these symptoms by taking slow deep breaths and trying to relax during the procedure. What kinds of procedures can be done during a cystoscopy? Besides examination, small bladder stones or tumors can be removed, small tissue samples and special x-rays can be taken, and a urinary stent can be inserted or removed. What to expect after a cystoscopy? There are often very few symptoms after a cystoscopy; however, there can be:» A strong urge to pass urine right after the procedure is finished» A burning sensation when passing urine (during and after)» Possible increase in frequency of voiding (passing urine)» Urine with a pinkish-tinge (should clear in 2-3 days)» A small amount of bright bleeding the first time you void These symptoms can often be relieved by drinking 8 to 10 glasses of fluid a day. If any of these symptoms lasts longer than 2 or 3 days, call the doctor who did the procedure.

DISCHARGE INFORMATION Length of Stay When a local anesthetic is used you may drive yourself home immediately following the procedure. However, if you have an IV sedation or a general anesthetic, you must arrange to have someone drive you home from the hospital and stay with you for a few hours following. Pain You may take warm tub baths. Try doing this if you are unable to void or feel very uncomfortable. A warm tub bath can relieve pain, relax your muscles, and may help you to pass urine. Medication You may be given a prescription for antibiotics to help prevent infection. If so, take this medication as directed until completed. Your doctor may also give you a prescription for pain medication. If not, you may take acetaminophen (for example, Tylenol). Follow the directions on the package or ask your doctor or pharmacist. Diet You may resume eating your usual diet as you feel able. Drink at least 8 to 10 glasses of fluid a day. Water, cranberry juice and other clear liquids are especially good. Activity You may resume your regular activities as you feel able.

Warning signs Call the doctor who did your procedure if you have any of the following problems:» Sudden chills or shaking» Fever (temperature over 38 C or 100.4 F)» Voiding very frequently, unable to void (pass urine), or unable to empty your bladder when you void» Cloudy or foul-smelling urine» Severe pain in abdomen or groin area» Bright bleeding in the urine that lasts more than 2 to 3 days» Increasing number or size of clots after the procedure» A burning sensation when passing urine that lasts longer than 48 hours If you are unable to reach a doctor, go to a hospital Emergency Department. If possible, go to the hospital where your procedure was done. Follow-up Call your doctor s office to arrange a follow-up visit, if required. You are encouraged to discuss any questions or concerns with your doctor.

SPECIAL NOTE» You may eat breakfast or dinner before the exam.» You may take all prescribed medications before the exam. Please call to inform us before your procedure if:» You have a latex allergy» If you have mitral valve prolapse or any artificial heart valves or grafts» If you routinely take antibiotics before dental work or surgery. Altru Clinic - Main: 701-780-6000 Ambulatory Procedures Center: 701-780-6394

6012-2161 FEB 09